Clinical Rheumatology

, Volume 32, Issue 2, pp 267–270

Leflunomide in dialysis patients with rheumatoid arthritis—a pharmacokinetic study

  • Raoul Bergner
  • Lena Peters
  • Verena Schmitt
  • Christian Löffler
Brief Report

DOI: 10.1007/s10067-012-2122-1

Cite this article as:
Bergner, R., Peters, L., Schmitt, V. et al. Clin Rheumatol (2013) 32: 267. doi:10.1007/s10067-012-2122-1

Abstract

Pharmacokinetic data of disease modifying antirheumatic drugs during hemodialysis are limited to sulfasalazine, methotrexate, and cyclosporine. Only respective anecdotal data have been reported on leflunomide. We repeatedly measured teriflunomide (A77-1726), the active metabolite of leflunomide, during standard hemodialysis sessions and calculated teriflunomide clearances in five patients with rheumatoid arthritis (RA) and end-stage renal disease. The calculated teriflunomide clearances during a standardized dialysis session of 3–4.5 h at a blood flow rate of 160–300 ml/min were between 0 and 4.3 ml/min, the mean clearances of the total dialysis ranged between 1.1 and 3.4 ml/min. Total amount of teriflunomide removed was 5.8–8.8 μg per dialysis session. Dialytic removal of the active metabolite of leflunomide, teriflunomide (A77-1726), is negligible. Leflunomide can be used for RA patients on chronic dialysis without any dosage modification.

Keywords

DialysisEnd-stage renal diseaseLeflunomidePharmacokineticsRheumatoid arthritis

Copyright information

© Clinical Rheumatology 2012

Authors and Affiliations

  • Raoul Bergner
    • 1
  • Lena Peters
    • 1
  • Verena Schmitt
    • 1
  • Christian Löffler
    • 1
  1. 1.Medizinische Klinik A, Klinikum LudwigshafenLudwigshafenGermany